中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
13期
911-914
,共4页
王秋曦%张震宇%王淑珍%刘军
王鞦晞%張震宇%王淑珍%劉軍
왕추희%장진우%왕숙진%류군
细胞学%不典型腺细胞%组织病理学%人乳头瘤病毒%宫颈上皮内瘤变
細胞學%不典型腺細胞%組織病理學%人乳頭瘤病毒%宮頸上皮內瘤變
세포학%불전형선세포%조직병이학%인유두류병독%궁경상피내류변
Cytologic%Atypical glandular cells%Histopathology%Human papilloma virus%Cervical intraepithelial neoplasia
目的 探讨高危型人乳头瘤病毒检测(HPV DNA test)和组织病理学诊断在宫颈细胞学的结果为不典型腺上皮细胞(AGC)中的关系及临床意义.方法 选择2007年1月至2009年12月北京朝阳医院阴道镜门诊就诊的97例宫颈细胞学AGC患者,分析其宫颈活检、分段诊刮、宫颈LEEP术的组织病理结果及HR HPV DNA检测的结果.结果 (1)65例(67.01%)病理异常:2例腺癌;63例(96.92%)宫颈鳞状上皮内瘤变(CIN)中40例LSIL、17例HSIL、6例鳞癌.(2)97例行HRHPV检测,其中阳性39例.在高度病变17例及宫颈癌8例中,HR-HPV检测阳性24例,其敏感性96%,特异性92.86%,阳性预测值96%,阴性预测值92.86%.(3)97例中6例行子宫全切,手术后病理检查无异常发现.1例CIN1者失访,90/91例完成随访,随访率98.9%.第1次随访6例HRHPV检测阳性及3例细胞学异常者,于第2次随访时细胞学及HR HPV检测均阴性.结论 细胞学AGC的患者给予HR HPV检测以及立即的阴道镜检查,对正确诊断、及时治疗和因其较高的阴性预测值而对临床减少过度治疗、随访管理有重要的作用.
目的 探討高危型人乳頭瘤病毒檢測(HPV DNA test)和組織病理學診斷在宮頸細胞學的結果為不典型腺上皮細胞(AGC)中的關繫及臨床意義.方法 選擇2007年1月至2009年12月北京朝暘醫院陰道鏡門診就診的97例宮頸細胞學AGC患者,分析其宮頸活檢、分段診颳、宮頸LEEP術的組織病理結果及HR HPV DNA檢測的結果.結果 (1)65例(67.01%)病理異常:2例腺癌;63例(96.92%)宮頸鱗狀上皮內瘤變(CIN)中40例LSIL、17例HSIL、6例鱗癌.(2)97例行HRHPV檢測,其中暘性39例.在高度病變17例及宮頸癌8例中,HR-HPV檢測暘性24例,其敏感性96%,特異性92.86%,暘性預測值96%,陰性預測值92.86%.(3)97例中6例行子宮全切,手術後病理檢查無異常髮現.1例CIN1者失訪,90/91例完成隨訪,隨訪率98.9%.第1次隨訪6例HRHPV檢測暘性及3例細胞學異常者,于第2次隨訪時細胞學及HR HPV檢測均陰性.結論 細胞學AGC的患者給予HR HPV檢測以及立即的陰道鏡檢查,對正確診斷、及時治療和因其較高的陰性預測值而對臨床減少過度治療、隨訪管理有重要的作用.
목적 탐토고위형인유두류병독검측(HPV DNA test)화조직병이학진단재궁경세포학적결과위불전형선상피세포(AGC)중적관계급림상의의.방법 선택2007년1월지2009년12월북경조양의원음도경문진취진적97례궁경세포학AGC환자,분석기궁경활검、분단진괄、궁경LEEP술적조직병리결과급HR HPV DNA검측적결과.결과 (1)65례(67.01%)병리이상:2례선암;63례(96.92%)궁경린상상피내류변(CIN)중40례LSIL、17례HSIL、6례린암.(2)97례행HRHPV검측,기중양성39례.재고도병변17례급궁경암8례중,HR-HPV검측양성24례,기민감성96%,특이성92.86%,양성예측치96%,음성예측치92.86%.(3)97례중6례행자궁전절,수술후병리검사무이상발현.1례CIN1자실방,90/91례완성수방,수방솔98.9%.제1차수방6례HRHPV검측양성급3례세포학이상자,우제2차수방시세포학급HR HPV검측균음성.결론 세포학AGC적환자급여HR HPV검측이급립즉적음도경검사,대정학진단、급시치료화인기교고적음성예측치이대림상감소과도치료、수방관리유중요적작용.
Objective To evaluate the potential link between high-risk human papilloma virus (HPV) DNA testing and histological diagnosis in women referred for atypical glandular cells ( AGC) at Pap smear. Methods All cervical cytological examinations with the diagnosis of AGC between January 2007 and Dec 2009 were identified by means of a computerized database in 97 patients. The histopathological results of cervix were analyzed by colposcopic biopsy, dilatation and curettage ( D&C), cervical loop electrosurgical excision procedure(LEEP) and high-risk human papilloma virus DNA testing. Results ( 1 ) All patient were monitored by colposcopy, histopathology and HPV DNA test. Sixty-four patients had pathologic lesions. (2)In predicting the presence of high-grade of cervical intraepithelial neoplasia, the sensitivity of human papilloma virus was 96%, specificity 92. 86%, positive predictive value 96% and negative predictive value 92. 86%. (3)98. 9% of the AGC patients received colposcopic, cytological examinations and HPV test at follow-ups: 3 cases of PAP smear and 6 cases of HPV testing were abnormal at the first follow-up, and 100% negative for cytological examination and HPV test at the second follow-up visit. Conclusion HPV DNA test and colposcopic examination are effective in the initial evaluation and subsequent follow-ups of cytological atypical glandular cells.
